Combined spinal interbody and plate assemblies

ABSTRACT

A spinal implant assembly combines a spinal interbody spacer with a spine plate. The combined spacer and plate assembly provides stabilization and torsional resistance to promote fusion of adjacent vertebrae. The spacer is configured for placement within an intervertebral space between the adjacent vertebrae previously occupied by a spinal disc. The plate is configured for attachment to anterior sides of the adjacent vertebrae. Translation of the spinal plate allows it to be affixed to the vertebrae in various positions and/or allow movement post installation. In one form, the plate is defined by first and second spine plate or plate portions that are coupled to one another to allow rotation about each other. Ends of the first and second spine plates are received in/by the interbody spacer, while a pin extends through the interbody spacer to fix the first and second spine plates to the interbody spacer.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. patent applicationSer. 12/836,285 filed Jul. 14, 2010 which claims priority to U.S.Provisional Patent Application Ser. No. 61/225,356 filed Jul. 14, 2009,entitled “Combined Spinal Interbody and Plate Assemblies”, both of whichare hereby incorporated herein by reference.

BACKGROUND

The present invention relates to spinal implants for the stabilization,distraction, support and/or the promotion of bone fusion betweenadjacent vertebrae of the spine.

Background Information

Because of disease, injury or deformity the disc that is betweenadjacent vertebrae of the human spine may become damaged. Additionally,the disc may simply deteriorate due to age or congenital defect. Inthese and in other circumstances, one or more vertebrae may becomecompressed or otherwise damaged. Moreover, the vertebrae can become tooclosely spaced which causes an undesired abnormal curvature of thespine. Such conditions may also cause a nerve to be pinched, creatingpain, numbness and/or other symptoms. In these situations it is thennecessary to provide support and/or alignment to and between adjacentvertebrae of the patient's spine. This is generally accomplished throughspinal surgery.

With spinal surgery, one or more spinal implants, spacers,intervertebral devices or interbody devices (collectively, spinalspacers) are placed between adjacent vertebrae once the disc has beenremoved. This provides proper spacing of the vertebrae. The spinalspacer may also promote fusion between the adjacent vertebrae.

Once the spinal spacer has been implanted into the intervertebral space,it is important that the spinal spacer remain in its implanted position.In addition to remaining in place, the spinal spacer must also be ableto handle the load that is imparted thereto from the adjacent vertebrae.

Accordingly, there exists a need for a spinal spacer that remains inplace once implanted and provides stabilization and torsional resistanceto promote fusion.

SUMMARY

The present invention is a spinal prosthesis or implant comprising acombined spinal interbody spacer and plate assembly. The combined spinalinterbody spacer and plate assembly provides stabilization and torsionalresistance to promote fusion of adjacent vertebrae of the spine.

The interbody spacer of the combined spinal interbody spacer and plateassembly is configured for placement within an intervertebral spacebetween adjacent vertebrae previously occupied by a spinal disc. Thespinal plate thereof is configured for attachment to anterior sides ofthe adjacent vertebrae (either on or within the vertebrae).

The spinal plate may dynamize, adjust or translate relative to theinterbody spacer, or it may be static or fixed relative to the interbodyspacer. Movement of the spinal plate allows it to be affixed to thevertebrae in various positions and/or allow movement post installation.The spinal plate may be positioned to provide initial compression of thevertebrae, allow or not allow post installation compression or provideother post installation movement. Accordingly, the spinal plate mayfurther translate during further vertebral movement (e.g. compression)depending on the initial fixation position thereof.

In one form, the spinal plate is defined by first and second spineplates or plate portions that are coupled to one another to allowrotation about each other. Rotation provides for variable spine platepositioning and/or relative motion of the plates post installation. Inone form, the first and second spine plates are coupled via a pin toallow rotation about each other. Ends of the first and second spineplates are received in/by the interbody spacer, while the pin extendsthrough the interbody spacer to fix the first and second spine plates tothe interbody spacer.

The pin may be retained by the interbody spacer so as to allow ananterior/posterior sliding motion between the pin and the interbodyspacer such that the position of the interbody spacer within theintervertebral space does not change when the first and second spineplates rotate during compression of the adjacent vertebrae.

The spine plates may be mounted relative to or on the adjacent vertebraeto either allow rotation of the plates or not allow rotation of theplates during compression of the adjacent vertebrae. If the spine platesare mounted to the adjacent vertebrae when in a fully rotated,translated or open position, the spine plate can rotate further when theadjacent vertebrae are compressed. If the spine plates are mounted tothe adjacent vertebrae when in a fully non rotated, translated or closedposition, the spine plates cannot rotate when the adjacent vertebrae arecompressed.

The first and second spine plates may optionally include mating ratchetfeatures so that the position of the first and second plates is lockedbetween intervals of translation while the adjacent vertebrae are alwayscompressing on the interbody spacer. The mating ratchet features may bepositioned on arms of the first and second spine plates.

In another form, the spinal plate is defined by first and second spineplates or plate portions that are movably retained by the interbodyspacer. Such movement may be independent. The spine plates are coupledto the interbody spacer for superior/inferior movement relative thereto.In one form of this embodiment, each spine plate has tangs on bothlateral sides of the plate body, each tang of which is movably connectedto the interbody spacer. In a static form of the invention, the tangsare rendered immobile so as to prevent translation of either or both ofthe spine plates.

In all cases, the first and second spine plates each have one, two ormore screw holes for accepting a bone screw for fixing the spine platesto the adjacent vertebrae.

BRIEF DESCRIPTION OF THE DRAWINGS

The above mentioned and other features, advantages and/or objects ofthis invention, and the manner of attaining them, will become apparentand the invention itself will be better understood by reference to thefollowing description of embodiments of the invention taken inconjunction with the accompanying drawings, wherein:

FIG. 1 is a perspective view of an embodiment of a combined spinalinterbody and plate fashioned in accordance with the present principles,the spine plate formed as a two-screw alignment/tension spine plate andshown in an open or dynamized position;

FIG. 2 is a front (anterior) view of the open combined spinal interbodyand two-screw alignment/tension spine plate of FIG. 1;

FIG. 3 is a side view of the open combined spinal interbody andtwo-screw alignment/tension spine plate of FIG. 1 taken along line 3-3of FIG. 2;

FIG. 4 is a sectional view of the open combined spinal interbody andtwo-screw alignment/tension spine plate of FIG. 1 taken along line 4-4of FIG. 2;

FIG. 5 is an enlarged portion of the sectional view of FIG. 4 takenalong circle 5-5 thereof;

FIG. 6 is a front (anterior) view of the combined spinal interbody andtwo-screw alignment/tension spine plate of FIG. 1 shown in a closed orun-dynamized position;

FIG. 7 is a side view of the closed combined spinal interbody andtwo-screw alignment/tension spine plate of FIG. 6 taken along line 7-7thereof;

FIG. 8 is a sectional view of the closed combined spinal interbody andtwo-screw alignment/tension spine plate of FIG. 6 taken along line 8-8thereof;

FIG. 9 is an enlarged portion of the sectional view of FIG. 8 takenalong circle 9-9 thereof;

FIG. 10 is a perspective view of an embodiment of a combined spinalinterbody and plate fashioned in accordance with the present principles,the spinal plate formed as a four-screw alignment/tension spine plateand shown in an open or dynamized position;

FIG. 11 is a front (anterior) view of the open combined spinal interbodyand four-screw alignment/tension spine plate of FIG. 10;

FIG. 12 is a side view of the open combined spinal interbody andfour-screw alignment/tension spine plate of FIG. 10 taken along line12-12 of FIG. 11;

FIG. 13 is a sectional view of the open combined spinal interbody andfour-screw alignment/tension spine plate of FIG. 10 taken along line13-13 of FIG. 11;

FIG. 14 is a front (anterior) view of an embodiment of another combinedspinal interbody and plate fashioned in accordance with the presentprinciples, the spinal plate formed as a four-screw alignment/tensionspine plate and shown in an open or dynamized position;

FIG. 15 is a side view of the open combined spinal interbody andfour-screw alignment/tension spine plate of FIG. 14 taken along line15-15 of FIG. 14;

FIG. 16 is a perspective view of the open combined spinal interbody andfour-screw alignment/tension spine plate of FIG. 14;

FIG. 17 is a front (anterior) view of the combined spinal interbody andfour-screw alignment/tension spine plate of FIGS. 14-16 but shown in aclosed or un-dynamized position;

FIG. 18 is a side view of the closed combined spinal interbody andfour-screw alignment/tension spine plate of FIG. 17 taken along line18-18 of FIG. 17;

FIG. 19 is a perspective view of the closed compressed combined spinalinterbody and four-screw alignment/tension spine plate of FIG. 17;

FIG. 20 is a front (anterior) view of an embodiment of a static combinedspinal interbody and plate fashioned in accordance with the presentprinciples, the spinal plate formed as a four-screw alignment/tensionspine plate;

FIG. 21 is a side view of the static combined spinal interbody andfour-screw alignment/tension spine plate of FIG. 20 taken along line21-21 thereof;

FIG. 22 is a perspective view of the static combined spinal interbodyand four-screw alignment/tension spine plate of FIG. 20; and

FIG. 23 is a perspective view of another combined spinal interbody andplate fashioned in accordance with the present principles, the spinalplate formed as a four-screw alignment/tension plate and shown in anopen or dynamized position.

Like reference numerals indicate the same or similar parts throughoutthe several figures.

A description of the features, functions and/or configuration of thecomponents depicted in the various figures will now be presented. Itshould be appreciated that not all of the features of the components ofthe figures are necessarily described. Some of these non-discussedfeatures, if any, as well as discussed features are inherent from thefigures. Other non-discussed features may be inherent in componentgeometry and/or configuration.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION

Referring to FIGS. 1-9, there is depicted various views of an embodimentof a spinal prosthesis comprising a combined spinal interbody and platefashioned in accordance with the present principles. The present spinalprosthesis may also be described as an intervertebral spinal spacer andspine plate assembly. The present spinal prosthesis may also bedescribed in other manners and/or nomenclatures. The present spinalprosthesis provides stabilization and torsional resistance to promotefusion of adjacent vertebrae of the spine.

The intervertebral spinal spacer and spine plate assembly, generallydesignated 10 (the “assembly 10”), is a two-screw spine plate embodimentwherein a single screw is used in each adjacent vertebrae for mountingthereof. The assembly 10 is characterized by an intervertebral spinalspacer (intervertebral spacer) 12 and a spine plate 14. Theintervertebral spacer 12 is formed of a body 18 that is sized andconfigured for reception in an intervertebral space between adjacentvertebrae in which a spinal disc was previously situated. The body 18 isthus designed to fit within an intervertebral space. In the presentembodiment, the body 18 is generally disc-shaped. It should beappreciated that the body 18 may be configured differently whileadhering to the present principles.

The body 18 has a first side 20, a second side 22, a posterior end 27,an anterior end 23, a first lateral side 19 and a second lateral side21, the nomenclature first and second being arbitrary. The first side 20may be considered the superior side while the second side 22 may beconsidered the inferior side. It should be appreciated, however, thatthe second side may be considered the superior side while the first sidemay be considered the inferior side. Hereinafter, however, the firstside 20 will be considered the superior side while the second side 22will be considered the inferior side. The body 18 includes first andsecond cavities 24, 25 that extend from and between the first and secondsides 20, 22.

As best seen in FIGS. 3 and 4, the first side 20 slopes downwardly fromthe anterior end 23 to the posterior end 27 of the body 18 while thesecond side 22 slopes upwardly from the anterior end 23 to the posteriorend 27 to define a wedge shape. It should be appreciated, however, thatthe body 18 may not be necessarily wedge-shaped, but instead have aparallel or reversed wedge-shape configuration. Other configurations arecontemplated. The first side 20 has a plurality of teeth that areconfigured so as to slant or angle in the anterior direction. Likewise,the second side 22 has a plurality of teeth that are configured so as toslant or angle in the anterior direction. When installed in theintervertebral space of adjacent vertebrae from the anterior side to theposterior side, the teeth provide an anti back-out mechanism. The body18 also includes a bore 28 that extends from and between the first andsecond lateral sides 19, 21 of the body 18. A pin 34 is disposed in thebore 28 and likewise extends from and between the first and secondlateral sides 19, 21 of the body 18. As described in detail below, thepin 34 pivotally holds the spine plate construct 14 and particularly,the first and second spine plate portions 36 and 42 thereof within acavity 26 of the body 18, the cavity 26 provided in the anterior end 23of the body 18.

The spine plate 14 is characterized by a first spine plate portion 36and a second spine plate portion 42, with the nomenclature first andsecond again being arbitrary. The first spine plate portion 36 has abone screw boss 41 having a tapered bore 45 that is sized and configuredto receive the head 31 of a bone screw 16 and to allow the axialpositioning of the threaded shank 30 of the bone screw 16 to be variablerelative to the bone screw boss 41. The head 31 of the bone screw 16 isshown with a configured socket 32. The second spine plate portion 42 hasa bone screw boss 44 having a tapered bore 46 that is sized andconfigured to receive the head 31 of a bone screw 16 and to allow theaxial positioning of the threaded shank 30 of the bone screw 16 to bevariable relative to the bone screw boss 45. It should be appreciatedthat the bore 46 may be sized and configured for a fixed axial positionof the bone screw.

The first spine plate portion 36 has a first angled arm 38 extendingfrom one side of the bone screw boss 41 and a second angled arm 39extending from another side of the bone screw boss 41. The arms 38 and39 form forks or tines of the first spine plate portion 36. A slot 40 isthus defined between the first and second angled arms 38, 39. The secondspine plate portion 42 has an angled arm 43 extending from a middle ofthe bone screw boss 44. The spine plate 14 comprises the coupled firstand second spine plate portions 36, 42. Particularly, the angled arm 43of the second spine plate portion 42 extends through the slot 40 betweenthe first and second arms 38, 39 of the first spine plate portion 36 andis pivotally coupled (i.e. hinged) to the first and second arms 38, 39via the pin 34 (see, e.g. FIGS. 4 and 5). Other manners of providing apivoting spine plate may be used and are contemplated.

The spine plate 14 is thus received in the intervertebral spacer 12 bythe reception of the arms 38, 39 and 43 in the cavity 26 of theintervertebral spacer 12 and retained by the pin 34. The first andsecond spine plate portions 36, 42 are thus free to rotate about the pin34 in order to properly position the corresponding bone screw bosses 41,44 relative to the adjacent vertebrae for securing the plate portionsonto the adjacent vertebrae. The slot 34 is sized to allowanterior/posterior movement of the spine plate 14 relative to theintervertebral spacer 12. It should be appreciated however, that theslot 34 may be sized to not allow such movement.

The spinal prosthesis 10 of FIGS. 1-5 is shown in a generally fullyextended, translated, rotated, open or dynamized position. In thisposition, the first and second spine plate portions 36, 42 are pivotedor rotated away from each other the most that they can be rotated whilestill being associated with the intervertebral spacer 12 (i.e. the firstspine plate portion 36 being rotated in the counterclockwise directionwith the second spine plate portion 42 being rotated in the clockwisedirection the most that the spine plate portions 36 and 42 can rotate).

When installed in this position, the spine plate 14 (the spine plateportions 36 and 42) allow vertebral compression. Particularly, there ismovement, compression or dynamization allowed between the spine plateportions and the intervertebral spacer.

In contrast to the position of the spinal prosthesis 10 of FIGS. 1-5,FIGS. 6-9 depict the spinal prosthesis 10 in a generally fullycompressed, non-translated, non-rotated, closed or un-dynamizedposition. In this position, the first and second spine plate portions36, 42 are pivoted or rotated toward each other the most that they canbe rotated while still being associated with the intervertebral spacer12 (i.e. the first spine plate portion 36 being rotated in thecounterclockwise direction with the second spine plate portion 42 beingrotated in the clockwise direction the most that the spine plateportions 36 and 42 can rotate).

When installed in this position, the spine plate 14 (the spine plateportions 36 and 42) does not allow vertebral compression. Particularly,there is no further compression movement or dynamization allowed betweenthe spine plate portions (i.e. they cannot close any more relative toone another).

Referring to FIGS. 10-13, there is depicted various views of anembodiment of a spinal prosthesis comprising a combined spinal interbodyand plate fashioned in accordance with the present principles. Thepresent spinal prosthesis may also be described as an intervertebralspinal spacer and spine plate assembly. The present spinal prosthesismay also be described in other manners and/or nomenclatures. The presentspinal prosthesis provides stabilization and torsional resistance topromote fusion of adjacent vertebrae of the spine.

The intervertebral spinal spacer and spine plate assembly, generallydesignated 50 (the “assembly 50”), is a four-screw spine plateembodiment wherein two screws are used in each adjacent vertebrae formounting thereof. The assembly 50 is characterized by an intervertebralspinal spacer (intervertebral spacer) 12 and a spine plate 52. Theintervertebral spacer 12 is the same as that described above withrespect to the embodiment of FIGS. 1-9 and thus reference is madethereto for an understanding thereof.

The spine plate 52 is characterized by a first spine plate portion 54and a second spine plate portion 56, with the nomenclature first andsecond again being arbitrary. The first spine plate portion 54 isdefined by a plate 55 having two bone screw bosses each having a taperedbore that is sized and configured to receive the head 31 of a bone screw16 and to allow the axial positioning of the threaded shank 30 of thebone screw 16 to be variable relative to the bone screw bosses and thusthe plate 55 (not necessarily variable; can also be fixed). The secondspine plate portion 56 is defined by a plate 57 having two bone screwbosses each having a tapered bore that is sized and configured toreceive the head 31 of a bone screw 16 and to allow the axialpositioning of the threaded shank 30 of the bone screw 16 to be variablerelative to the bone screw bosses and thus the plate 57.

The first spine plate portion 54 has a first angled arm 58 extendingfrom one side of the plate 55 and a second angled arm 59 extending fromanother side of the plate 55; the arms 58, 59 forming forks or tines. Aslot 60 is defined between the first and second angled arms 58, 59. Thesecond spine plate portion 56 has an angled arm 62 extending from amiddle of the plate 57. The spine plate 14 comprises the coupled firstand second spine plate portions 54, 56. Particularly, the angled arm 62of the second spine plate portion 56 extends through the slot 60 betweenthe first and second arms 58, 59 of the first spine plate portion 54 andis pivotally coupled (i.e. hinged) to the first and second arms 58, 59via the pin 34 (see, e.g. FIG. 13).

The spine plate construct 52 is thus received in the intervertebralspacer 12 by the reception of the arms 58, 59 and 62 in the cavity 26 ofthe intervertebral spacer 12 and retained by the pin 34. The first andsecond spine plate portions 54, 56 are thus free to rotate about the pin34 in order to properly position the corresponding bone screwbosses/plates 55, 57 relative to the adjacent vertebrae for securing theplate portions onto the adjacent vertebrae. The slot 34 is sized toallow anterior/posterior movement of the spine plate 52 relative to theintervertebral spacer 12. It should be appreciated however, that theslot 34 may be sized to not allow such movement.

The spinal prosthesis 50 of FIGS. 10-13 is shown in a generally fullyextended, translated, rotated, open or dynamized position. In thisposition, the first and second spine plate portions 54, 56 are pivotedor rotated away from each other the most that they can be rotated whilestill being associated with the intervertebral spacer 12 (i.e. the firstspine plate portion 54 being rotated in the counterclockwise directionwith the second spine plate portion 56 being rotated in the clockwisedirection the most that the spine plate portions 54 and 56 can rotate).

When installed in this position, the spine plate 52 (the spine plateportions 54 and 56) allow vertebral compression. Particularly, there ismovement, compression or dynamization allowed between the spine plateportions and the intervertebral spacer.

In another embodiment of the design, two plates are attached to theintervertebral spacer via two pins that extend from the superior toinferior surfaces of the spacer. The plates are allowed to translatealong the pins or dynamize to accommodate subsidence within the discspace. In the form shown, the screws are contained within disc space andcan be screwed into the superior and inferior faces of the vertebralbodies. In another form, the screws can be screwed into anterior facesof the vertebral bodies.

Referring now to FIGS. 14-16, there is depicted various views of anotherembodiment of a spinal prosthesis comprising a combined spinal interbodyand plate fashioned in accordance with the present principles. Thepresent spinal prosthesis may also be described as an intervertebralspacer and spine plate assembly. The present spinal prosthesis may alsobe described in other manners and/or nomenclatures. The present spinalprosthesis provides stabilization and torsional resistance to promotefusion of adjacent vertebrae of the spine.

The interbody and spine plate assembly, generally designated 70 (the“assembly 70”), is a four-screw spine plate embodiment wherein twoscrews are used in each adjacent vertebrae for mounting thereof. Theassembly 70 is characterized by an interbody 72 and a spine plate 74.The interbody 72 is formed of a body 75 that is sized and configured forreception in an interbody space. The body 75 is thus designed to fitwithin an interbody space. In the present embodiment, the body 75 isgenerally D-shaped or semi disc-shaped. It should be appreciated thatthe body 75 may be configured differently while adhering to the presentprinciples.

The body 75 has a first side 78, a second side 79, a posterior end 76,an anterior end 77, a first lateral side 102 and a second lateral side103, the nomenclature first and second being arbitrary. The first side78 may be considered the superior side while the second side 79 may beconsidered the inferior side. It should be appreciated, however, thatthe second side may be considered the superior side while the first sidemay be considered the inferior side. Hereinafter, however, the firstside 78 will be considered the superior side while the second side 79will be considered the inferior side. The body 75 includes first andsecond cavities 108, 109 that extend from and between the first andsecond sides 78, 79.

As best seen in FIG. 15, the first side 78 slopes slightly downwardlyfrom the anterior end 77 to the posterior end 76 of the body 75 whilethe second side 79 slopes slightly upwardly from the anterior end 77 tothe posterior end 76 to define a wedge shape. It should be appreciated,however, that the body 75 may not be necessarily wedge-shaped, butinstead have a parallel or reversed wedge-shape configuration. Otherconfigurations are contemplated. The first side 78 has a plurality ofteeth that are configured so as to slant or angle in the anteriordirection. Likewise, the second side 79 has a plurality of teeth thatare configured so as to slant or angle in the anterior direction. Wheninstalled in the intervertebral space of adjacent vertebrae from theanterior side to the posterior side, the teeth provide an anti back-outmechanism.

The body 75 also includes a first upper flange 82 that extends in theposterior direction from the first lateral side 102 of the body 75 and afirst lower flange 84 that extends in the posterior direction from thefirst lateral side 102 of the body 75. A vertical bore 83 extendsthrough the first upper flange 82 while a vertical bore 85 extendsthrough the first lower flange 84. A pin, dowel, rod or the like 90extends through the first upper flange bore 83 and the first lowerflange bore 85.

The body 75 further includes a second upper flange 86 that extends inthe posterior direction from the second lateral side 103 of the body 75and a second lower flange 88 that extends in the posterior directionfrom the second lateral side 103 of the body 75. A vertical bore 87extends through the second upper flange 86 while a vertical bore (notseen) extends through the second lower flange 88. A pin, dowel, rod orthe like 91 extends through the second upper flange bore 86 and thesecond lower flange bore (not seen).

A space 80 is defined between the first upper flange 82 and the firstlower flange 84. The space 80 provides an area of translation for oneside of the spine plate 74. A space 81 is defined between the secondupper flange 86 and the second lower flange 88. The space 81 provides anarea of translation for another side of the spine plate 74. In thismanner, the spine plate 74 can provide for dynamization.

The spine plate 74 is characterized by a first spine plate portion 94and a second spine plate portion 96, with the nomenclature first andsecond again being arbitrary. The first spine plate portion 94 has afirst configured bone screw bore 98 that is sized and configured toreceive the head 31 of a bone screw 16 and to allow the axialpositioning of the threaded shank 30 of the bone screw 16 to be variablerelative to the bone screw bore 98. The first spine plate portion 94 hasa second configured bone screw bore 99 that is sized and configured toreceive the head 31 of a bone screw 16 and to allow the axialpositioning of the threaded shank 30 of the bone screw 16 to be variablerelative to the bone screw bore 98. It should be appreciated that thebone screw bores 98, 99 may be configured to provide a fixed angleand/or positioning of the bone screw 16 therein.

The second spine plate portion 96 has a first configured bone screw bore100 that is sized and configured to receive the head 31 of a bone screw16 and to allow the axial positioning of the threaded shank 30 of thebone screw 16 to be variable relative to the bone screw bore 100. Thesecond spine plate portion 96 has a second configured bone screw bore101 that is sized and configured to receive the head 31 of a bone screw16 and to allow the axial positioning of the threaded shank 30 of thebone screw 16 to be variable relative to the bone screw bore 101. Itshould be appreciated that the bone screw bores 100, 101 may beconfigured to provide a fixed angle and/or positioning of the bone screw16 therein.

The first spine plate portion 94 has a first tang 104 on a first lateralside thereof (proximate the lateral side 102 of the body 75) and asecond tang 106 on a second lateral side thereof (proximate the lateralside 103 of the body 75). The first tang 104 includes a bore 111 that issized to fit about pin 90. The second tang 106 includes a bore therein(not seen) that is sized to fit about the pin 91. In this manner, thefirst plate portion 94 may translate, move or dynamize in thesuperior/inferior direction.

The second spine plate portion 96 has a first tang 105 on a firstlateral side thereof (proximate the lateral side 102 of the body 75) anda second tang 107 on a second lateral side thereof (proximate thelateral side 103 of the body 75). The first tang 105 includes a bore 113that is sized to fit about pin 90. The second tang 106 includes a boretherein (not seen) that is sized to fit about the pin 91. In thismanner, the second plate portion 96 may translate, move or dynamize inthe superior/inferior direction in the same manner as first plateportion 94.

The spine plate 74 is thus retained by the interbody 72 through captureof the tangs 104, 105, 106, 107 by the pins 90, 91. The first and secondspine plate portions 64, 96 are thus free to move or translate on/alongthe length of the pins 90, 91 in the superior/inferior direction inorder to properly position the corresponding bone screw bosses 98, 99,100, 101 relative to the adjacent vertebrae for securing the plateportions onto the adjacent vertebrae. Each spine plate portion 94, 96has an independent fully open, extended, moved, translated orun-dynamized position such as depicted in the figures when the tangs104, 105, 106, 107 are closest the respective flanges 82, 84, 86, 88 ofthe body 75.

The spinal prosthesis 70 of FIGS. 14-16 is thus shown in a generallyfully extended, translated, moved, open or dynamized position. In thisposition, both of the first and second spine plate portions 94, 96 aretranslated away from each other the most axial distance that they can.When installed in this position, the spine plate 74 (the spine plateportions 94 and 96) allow vertebral compression. Particularly, there ismovement, compression or dynamization allowed between the spine plateportions.

In contrast to the position of the spinal prosthesis 70 of FIGS. 14-16,FIGS. 17-19 depict the spinal prosthesis 70 in a generally fullycompressed, non-translated, non-moved, closed or un-dynamized position.In this position, the first and second spine plate portions 94, 96 aretranslated toward each other the most that they can be moved.

When installed in this position, the spine plate portions 94, 96 do notallow vertebral compression; therefore, the interbody 52 takes more ofthe load relative to the spine plate 74. Particularly, there is nofurther compression movement or dynamization allowed between the spineplate portions and the interbody (i.e. they can spread out relative toone another).

FIGS. 6-9 depict the spinal prosthesis 10 in a generally fullycompressed, non-translated, non-rotated, closed or un-dynamizedposition. In this position, the first and second spine plate portions36, 42 are pivoted or rotated toward each other the most that they canbe rotated while still being associated with the intervertebral spacer12 (i.e. the first spine plate portion 36 being rotated in thecounterclockwise direction with the second spine plate portion 42 beingrotated in the clockwise direction the most that the spine plateportions 36 and 42 can rotate).

When installed in this position, the spine plate 14 (the spine plateportions 36 and 42) does not allow vertebral compression. Particularly,there is no further compression movement or dynamization allowed betweenthe spine plate portions (i.e. they cannot close any more relative toone another).

Referring now to FIGS. 20-22, there is depicted various views of anotherembodiment of a spinal prosthesis comprising a combined, staticstand-alone spinal interbody assembly fashioned in accordance with thepresent principles. The present stand-alone spinal interbody assembly,generally designated 120, provides stabilization and torsionalresistance to promote fusion of adjacent vertebrae of the spine. InFIGS. 20-22, the spinal prosthesis 120 is a static stand-aloneprosthesis wherein the plates do not translate.

The static, stand-alone interbody assembly 120 is a four-screw spineplate embodiment wherein two screws are used in each adjacent vertebraefor mounting thereof. The assembly 120 is characterized by an interbody122 and a spine plate 124. The interbody 124 is formed of a body 125that is sized and configured in larger proportion than the previousinterbodies/intervertebral spacers, for reception in an interbody space.The body 125 is thus designed to fit within an interbody space. In thepresent embodiment, the body 125 is generally D-shaped or semidisc-shaped. It should be appreciated that the body 125 may beconfigured differently while adhering to the present principles.

The body 125 has a first side 128, a second side 129, a posterior end126, an anterior end 127, a first lateral side 140 and a second lateralside 142, the nomenclature first and second being arbitrary. The firstside 128 may be considered the superior side while the second side 129may be considered the inferior side. It should be appreciated, however,that the second side may be considered the superior side while the firstside may be considered the inferior side. Hereinafter, however, thefirst side 128 will be considered the superior side while the secondside 129 will be considered the inferior side. The body 125 includesfirst and second cavities 162, 164 that extend from and between thefirst and second sides 128, 129.

As best seen in FIG. 21, the first side 128 slopes slightly downwardlyfrom the anterior end 127 to the posterior end 126 of the body 125 whilethe second side 129 slopes slightly upwardly from the anterior end 127to the posterior end 126 to define a wedge shape. It should beappreciated, however, that the body 125 may not be necessarilywedge-shaped, but instead have a parallel or reversed wedge-shapeconfiguration. Other configurations are contemplated. The first side 128has a plurality of teeth that are configured so as to slant or angle inthe anterior direction. Likewise, the second side 129 has a plurality ofteeth that are configured so as to slant or angle in the anteriordirection. When installed in the intervertebral space of adjacentvertebrae from the anterior side to the posterior side, the teethprovide an anti back-out mechanism.

The body 125 also includes a first upper flange 132 that extends in theposterior direction from the first lateral side 140 of the body 125 anda first lower flange 134 that extends in the posterior direction fromthe first lateral side 140 of the body 125. A vertical bore 133 extendsthrough the first upper flange 132 while a vertical bore 135 extendsthrough the first lower flange 134. A pin, dowel, rod or the like 153extends through the first upper flange bore 133 and the first lowerflange bore 135.

The body 125 further includes a second upper flange 136 that extends inthe posterior direction from the second lateral side 142 of the body 125and a second lower flange 138 that extends in the posterior directionfrom the second lateral side 142 of the body 125. A vertical bore 137extends through the second upper flange 136 while a vertical bore (notseen) extends through the second lower flange 138. A pin, dowel, rod orthe like (not seen) extends through the second upper flange bore 136 andthe second lower flange bore (not seen) in like manner to pin 153.

A space 130 is defined between the first upper flange 132 and the firstlower flange 134. The space 130 provides an area of translation for oneside of each spine plate portion 144, 146. A space 131 is definedbetween the second upper flange 136 and the second lower flange 138. Thespace 131 provides an area of translation for another side of the spineplate portions 144, 146. While described below in more detail, themovement of the spine plate portions 144, 146 are rendered immobile orare limited in translation.

The spine plate 124 is characterized by a first spine plate portion 144and a second spine plate portion 146, with the nomenclature first andsecond again being arbitrary. The first spine plate portion 144 has afirst configured bone screw bore 156 that is sized and configured toreceive the head 31 of a bone screw 16 and to allow the axialpositioning of the threaded shank 30 of the bone screw 16 to be variablerelative to the bone screw bore 156. The first spine plate portion 144has a second configured bone screw bore 157 that is sized and configuredto receive the head 31 of a bone screw 16 and to allow the axialpositioning of the threaded shank 30 of the bone screw 16 to be variablerelative to the bone screw bore 157. It should be appreciated that thebone screw bores 156, 157 may be configured to provide a fixed angleand/or positioning of the bone screw 16 therein.

The second spine plate portion 146 has a first configured bone screwbore 158 that is sized and configured to receive the head 31 of a bonescrew 16 and to allow the axial positioning of the threaded shank 30 ofthe bone screw 16 to be variable relative to the bone screw bore 158.The second spine plate portion 136 has a second configured bone screwbore 159 that is sized and configured to receive the head 31 of a bonescrew 16 and to allow the axial positioning of the threaded shank 30 ofthe bone screw 16 to be variable relative to the bone screw bore 159. Itshould be appreciated that the bone screw bores 158, 159 may beconfigured to provide a fixed angle and/or positioning of the bone screw16 therein.

The first spine plate portion 144 has a first tang 148 on a firstlateral side thereof (proximate the lateral side 140 of the body 125)and a second tang 149 on a second lateral side thereof (proximate thelateral side 142 of the body 125). The first tang 148 includes a bore166 that is sized to fit about pin 153. The second tang 149 includes abore therein (not seen) that is sized to fit about a pin (not seen). Inthis manner, the first plate portion 144 may translate, move or dynamizein the superior/inferior direction if made possible.

The second spine plate portion 146 has a first tang 150 on a firstlateral side thereof (proximate the lateral side 140 of the body 125)and a second tang 151 on a second lateral side thereof (proximate thelateral side 142 of the body 125). The first tang 150 includes a bore168 that is sized to fit about pin 153. The second tang 151 includes abore therein (not seen) that is sized to fit about the pin (not seen).In this manner, the second plate portion 146 may translate, move ordynamize in the superior/inferior direction in the same manner as firstplate portion 144 if made possible.

The spine plate 124 is thus retained by the interbody 122 throughcapture of the tangs 148, 149, 150, 151 by the respective pins (notshown). The first and second spine plate portions 144, 146 are thus freeto move or translate on/along the length of the pins in thesuperior/inferior direction if permitted. However, a first washer 152 ispositioned on the pin 153 between the tang 148 of the first spine plateportion 144 and the tang 150 of the second spine plate portion 146. Thefirst washer 152 is generally cylindrical and is sized to prohibitmovement of the tangs 148, 150 and thus the first lateral sides of thefirst and second spine plate portions 144, 146. Moreover, a secondwasher 154 is positioned on the pin (not seen) between the tang 149 ofthe first spine plate portion 144 and the tang 151 of the second spineplate portion 146. The second washer 154 is generally cylindrical and issized to prohibit movement of the tangs 149, 151 and thus the secondlateral sides of the first and second spine plate portions 144, 146.Thus, the spine plate 124 is in a static, fully open, extended, moved,translated or un-dynamized position.

In this position, both of the first and second spine plate portions 144,146 are translated away from each other the most axial distance thatthey can. When installed in this position, retention of the spine plateportions 144 and 146 prohibit vertebral compression; therefore,vertebral spacing is retained and/or the spine plate 124 shares the loadwith the interbody 122. Particularly, there is no further extensionmovement or dynamization allowed between the spine plate portions andthe interbody (i.e. they cannot spread out any more relative to oneanother). It should be appreciated that the washers 152, 154 may be madeaxially smaller to permit limited movement of the plates.

Referring now to FIG. 23, there is depicted various views of anotherembodiment of a spinal prosthesis comprising a combined, dynamicstand-alone spinal interbody assembly fashioned in accordance with thepresent principles. The present stand-alone spinal interbody assembly,generally designated 170, provides stabilization and torsionalresistance to promote fusion of adjacent vertebrae of the spine.

The dynamic, stand-alone interbody assembly 170 is a four-screw spineplate embodiment wherein two screws are used in each adjacent vertebraefor mounting thereof. The assembly 170 is characterized by an interbody122 and a spine plate 124. The interbody 124 is formed of a body 125that is sized and configured in larger proportion than the previousinterbodies/intervertebral spacers, for reception in an interbody space.The body 125 is thus designed to fit within an interbody space. In thepresent embodiment, the body 125 is generally D-shaped or semidisc-shaped. It should be appreciated that the body 125 may beconfigured differently while adhering to the present principles.

The body 125 has a first side 128, a second side 129, a posterior end126, an anterior end 127, a first lateral side 140 and a second lateralside 142, the nomenclature first and second being arbitrary. The firstside 128 may be considered the superior side while the second side 129may be considered the inferior side. It should be appreciated, however,that the second side may be considered the superior side while the firstside may be considered the inferior side. Hereinafter, however, thefirst side 128 will be considered the superior side while the secondside 129 will be considered the inferior side. The body 125 includesfirst and second cavities 162, 164 that extend from and between thefirst and second sides 128, 129.

While not seen in the figures, the first side 128 slopes slightlydownwardly from the anterior end 127 to the posterior end 126 of thebody 125 while the second side 129 slopes slightly upwardly from theanterior end 127 to the posterior end 126 to define a wedge shape. Itshould be appreciated, however, that the body 125 may not be necessarilywedge-shaped, but instead have a parallel or reversed wedge-shapeconfiguration. Other configurations are contemplated. The first side 128has a plurality of teeth that are configured so as to slant or angle inthe anterior direction. Likewise, the second side 129 has a plurality ofteeth that are configured so as to slant or angle in the anteriordirection. When installed in the intervertebral space of adjacentvertebrae from the anterior side to the posterior side, the teethprovide an anti back-out mechanism.

The body 125 also includes a first upper flange 132 that extends in theposterior direction from the first lateral side 140 of the body 125 anda first lower flange 134 that extends in the posterior direction fromthe first lateral side 140 of the body 125. A vertical bore 133 extendsthrough the first upper flange 132 while a vertical bore 135 extendsthrough the first lower flange 134. A pin, dowel, rod or the like 172extends through the first upper flange bore 133 and the first lowerflange bore 135.

The body 125 further includes a second upper flange 136 that extends inthe posterior direction from the second lateral side 142 of the body 125and a second lower flange 138 that extends in the posterior directionfrom the second lateral side 142 of the body 125. A vertical bore 137extends through the second upper flange 136 while a vertical bore (notseen) extends through the second lower flange 138. A pin, dowel, rod orthe like 174 extends through the second upper flange bore 136 and thesecond lower flange bore (not seen) in like manner to pin 172.

A space 130 is defined between the first upper flange 132 and the firstlower flange 134. The space 130 provides an area of translation for oneside of each spine plate portion 144, 146. A space 131 is definedbetween the second upper flange 136 and the second lower flange 138. Thespace 131 provides an area of translation for another side of the spineplate portions 144, 146.

The spine plate 124 is characterized by a first spine plate portion 144and a second spine plate portion 146, with the nomenclature first andsecond again being arbitrary. The first spine plate portion 144 has afirst configured bone screw bore 156 that is sized and configured toreceive the head 31 of a bone screw 16 and to allow the axialpositioning of the threaded shank 30 of the bone screw 16 to be variablerelative to the bone screw bore 156. The first spine plate portion 144has a second configured bone screw bore 157 that is sized and configuredto receive the head 31 of a bone screw 16 and to allow the axialpositioning of the threaded shank 30 of the bone screw 16 to be variablerelative to the bone screw bore 157. It should be appreciated that thebone screw bores 156, 157 may be configured to provide a fixed angleand/or positioning of the bone screw 16 therein.

The second spine plate portion 146 has a first configured bone screwbore 158 that is sized and configured to receive the head 31 of a bonescrew 16 and to allow the axial positioning of the threaded shank 30 ofthe bone screw 16 to be variable relative to the bone screw bore 158.The second spine plate portion 136 has a second configured bone screwbore 159 that is sized and configured to receive the head 31 of a bonescrew 16 and to allow the axial positioning of the threaded shank 30 ofthe bone screw 16 to be variable relative to the bone screw bore 159. Itshould be appreciated that the bone screw bores 158, 159 may beconfigured to provide a fixed angle and/or positioning of the bone screw16 therein.

The first spine plate portion 144 has a first tang 148 on a firstlateral side thereof (proximate the lateral side 140 of the body 125)and a second tang 149 on a second lateral side thereof (proximate thelateral side 142 of the body 125). The first tang 148 includes a bore166 that is sized to fit about pin 172. The second tang 149 includes abore therein (not seen) that is sized to fit about a pin 174. In thismanner, the first plate portion 144 may translate, move or dynamize inthe superior/inferior direction along the pins 172, 174.

The second spine plate portion 146 has a first tang 150 on a firstlateral side thereof (proximate the lateral side 140 of the body 125)and a second tang 151 on a second lateral side thereof (proximate thelateral side 142 of the body 125). The first tang 150 includes a bore168 that is sized to fit about pin 172. The second tang 151 includes abore therein (not seen) that is sized to fit about the pin 174. In thismanner, the second plate portion 146 may translate, move or dynamize inthe superior/inferior direction in the same manner as first plateportion 144.

The spine plate 124 is thus retained by the interbody 122 throughcapture of the tangs 148, 149, 150, 151 by the respective pins 172, 174.The first and second spine plate portions 144, 146 are thus free to moveor translate on/along the length of the pins 172, 171 in thesuperior/inferior direction. Both of the first and second spine plateportions 144, 146 can translated away from and towards each other.

While not shown, it should be appreciated that spinal plate portions mayoptionally include mating ratchet features so that the position of thespinal plate portions is locked between intervals of dynamization andthe adjacent vertebrae. The mating ratchet features are positioned onarms of the spinal plate portions.

While the invention has been illustrated and described in detail in thedrawings and foregoing description, the same is to be considered asillustrative and not restrictive in character, it being understood thatonly preferred embodiments have been shown and described and that allchanges and modifications that come within the spirit of the inventionare desired to be protected.

1. A spinal implant comprising: a spacer configured for retentionbetween a first vertebrae and a second vertebrae, the spacer having acavity; a pin extending through the cavity of the spacer; a spine platecoupled to the spacer, the spine plate comprising: a first spine plateportion having a first end and a second end, the first end having a bonescrew bore to allow attachment of the first spine plate portion to thefirst vertebrae via a first bone screw, and the second end extendinginto the cavity and coupled to the pin; and a second spine plate portionhaving a first end and a second end, the first end having a second bonescrew bore to allow attachment to the second spine plate portion to thesecond vertebrae via a second bone screw, and the second end extendinginto the cavity and coupled to the pin; wherein the first spine plateportion and second spine plate portion are configured for translationalmovement and rotational movement relative to the spacer.
 2. The spinalimplant of claim 1, wherein the first spine plate and the second spineplate are connected by the pin for rotational movement relative to eachother.
 3. The spinal implant of claim 1, wherein: the first spine plateportion includes a first angled section between the first end and thesecond end so that the second end is at a first angle relative to thefirst end; and the second spine plate portion includes a second angledsection between the first end and the second end so that the second endis at a second angle relative to the first end.
 4. The spinal implant ofclaim 3, wherein the first angle is an obtuse angle and the second angleis an obtuse angle.
 5. The spinal implant of claim 1, wherein the firstbone screw bore is tapered for angled reception of the first bone screw,and the second bone screw bore is tapered for angled reception of thesecond bone screw.
 6. The spinal implant of claim 1, wherein the secondend of the first spine plate portion includes a pair of spaced apartarms, wherein the second of the second spine plate portion includes anangled arm located between the pair of spaced apart arms of the firstspine plate portion.
 7. The spinal implant of claim 1, wherein thetranslational movement of the first and second spine plate allowsmovement of the second end of the first spine plate portion and thesecond end of the second spine plate portion within the cavity in thespacer.
 8. The spinal implant of claim 1, wherein the spacer includes apair of opposed and aligned bores that are in communication with thecavity and receive ends of the pin.
 9. The spinal implant of claim 8,wherein the bores are elongated bores.
 10. The spinal implant of claim9, wherein the elongated bores extend entirely through opposed sidewallsof the spacer that at least partially define the cavity.
 11. A spinalimplant comprising: a spacer configured for retention between a firstvertebrae and a second vertebrae, the spacer having a cavity; a pinextending through the cavity of the spacer; a spine plate coupled to thespacer, the spine plate comprising: a first spine plate portion having afirst end, a second end, and an angled section connecting the first endand the second end, the first end having a bone screw bore to allowattachment of the first spine plate portion to the first vertebrae via afirst bone screw, and the second end located at least partially in thecavity and coupled to the pin; and a second spine plate portion having afirst end, a second end, and an angled section connecting the first endand the second end, the first end having a second bone screw bore toallow attachment to the second spine plate portion to the secondvertebrae via a second bone screw, and the second end located at leastpartially in the cavity and coupled to the pin; wherein the first spineplate portion and second spine plate portion are configured fortranslational movement and rotational movement relative to the spacerand to each other.
 12. The spinal implant of claim 11, wherein thesecond end of the first spine plate portion extends at a first anglerelative to the first end, and the second end of the second spine plateportion extends at a second angle relative to the second end.
 13. Thespinal implant of claim 12, wherein the first angle is an obtuse angleand the second angle is an obtuse angle.
 14. The spinal implant of claim11, wherein the second end of the first spine plate portion includes apair of spaced apart arms, wherein the second of the second spine plateportion includes an angled arm located between the pair of spaced apartarms of the first spine plate portion.
 15. The spinal implant of claim11, wherein the translational movement of the first and second spineplate allows movement of the second end of the first spine plate portionand the second end of the second spine plate portion within the cavityin the spacer.
 16. The spinal implant of claim 11, wherein the spacerincludes a pair of opposed and aligned bores that are in communicationwith the cavity and receive ends of the pin.
 17. The spinal implant ofclaim 16, wherein the elongated bores extend entirely through opposedsidewalls of the spacer that at least partially define the cavity.
 18. Aspinal implant comprising: a spacer configured for retention between afirst vertebrae and a second vertebrae, the spacer having a cavity; apin extending through the cavity of the spacer; a spine plate coupled tothe spacer, the spine plate comprising: a first spine plate portionhaving a first end and a second end extending at an acute angle relativeto the first end, the first end having a bone screw bore configured toreceive a first bone screw, and the second end located at leastpartially in the cavity and having a pair of spaced apart arms; and asecond spine plate portion having a first end and a second end extendingat an acute angle relative to the first end, the first end having a bonescrew bore configured to receive a first bone screw, and the second endlocated at least partially in the cavity and between the spaced apartarms of the first spine plate portion; wherein the first spine plateportion and second spine plate portion are coupled to the pin andbetween a first position and a second position are configured fortranslational movement and rotational movement relative to the spacerand to each other.
 19. The spinal implant of claim 18, wherein thetranslational movement of the first and second spine plate allowsmovement of the second end of the first spine plate portion and thesecond end of the second spine plate portion within the cavity in thespacer.
 20. The spinal implant of claim 18, wherein the spacer includesa pair of opposed and aligned bores that extend from the cavity throughopposed sidewalls of the spacer and receive ends of the pin.
 21. Thespinal implant of claim 18, wherein between the second position and athird position the first spine plate portion and the second spine plateportion are configured for translational movement without rotationalmovement.
 22. The spinal implant of claim 18, wherein the pin extendsthrough the second end of the first spine plate portion, the secondspine plate portion, and at least partially through the spacer.